October - December 2008, Volume 4, Issue 4

Mircescu G

Oxidative stress of chronic kidney disease

Acta Endo (Buc) 2008, 4 (4): 433-446
doi: 10.4183/aeb.2008.433

Oxidative stress is defined as a rupture in the prooxidant-antioxidant balance in favor of\r\nthe former, leading to characteristic changes in biomolecules of all types, and to tissue damage.\r\nIt was implied in ageing-related processes, both by direct actions of various oxidative adducts\r\nand by its cardiovascular consequences. In the latest years, it has become evident that chronic\r\nkidney disease (CKD) is itself a condition characterized by oxidative stress. Although\r\nconflictual results were reported in non-dialysis CKD patients, there is an increasing trend in\r\noxidative stress markers and a decreasing one in antioxidative activity along with progressive\r\nreduction in glomerular filtration rate. A combination of inflammation, abnormal nutrition,\r\ndisturbed metabolism by the uremic milieu and defective renal clearance seems to be the cause.\r\nClearly, longitudinal studies with larger participation are necessary to define the precise\r\ncontribution of each element and the relationships between oxidative stress and CKD\r\nprogression. In dialysis CKD patients, bioincompatibility reactions during HD sessions\r\n(dialyzor membrane, dialysis solution), anemia and its therapy (iv iron) come into play. The\r\nclinical consequences of oxidative stress are difficult to ascertain, because oxidative stress,\r\ninflammation and malnutrition were found to be, in various proportion, strong predictors of\r\noutcome in CKD patients, but the precise contribution of each factor is difficult to elucidate for\r\nthe moment.

Keywords: oxidative stress, AGE, AOPP, chronic kidney disease, dialysis

Correspondence: Gabriel Mircescu, MD, "Carol Davila" University of Medicine and Pharmacy,Bucharest, Romania, "Dr Carol Davila" Hospital of Nephrology, Bucharest, Romania, email:\r\ngmircescu@hotmail.com